More than 22 million infants around the world missed their first measles shots last year, which is the largest increase in two decades and could threaten progress toward eliminating the highly infectious disease, according to a new report.
The number of children who missed their first doses was up 3 million last year compared to 2019 and sets up “dangerous conditions for outbreaks to occur,” according to the report released Wednesday by the World Health Organization and Centers for Disease Control and Prevention.
“Large numbers of unvaccinated children, outbreaks of measles, and disease detection and diagnostics diverted to support COVID-19 responses are factors that increase the likelihood of measles-related deaths and serious complications in children,” said Dr. Kevin Cain, CDC’s global immunization director, in a statement. “We must act now to strengthen disease surveillance systems and close immunity gaps, before travel and trade return to pre-pandemic levels, to prevent deadly measles outbreaks and mitigate the risk of other vaccine-preventable diseases.”
Along with fewer children getting their first measles shots, only 70% of children got their second measles vaccine doses, below the 95% coverage needed to protect communities from measles outbreaks, the report’s researchers found.
While reported measles cases declined by more than 80% in 2020, the report notes that measles surveillance also diminished during the global pandemic, with the lowest specimen samples sent for lab testing in more than a decade. Public health officials say the lack of monitoring, testing and reporting of measles could hinder countries’ abilities to prevent outbreaks of the disease.
Dr. Kate O’Brien, director of WHO’s Department of Immunization, Vaccines and Biologicals, warns that although reported measles cases dropped last year, this is likely the “calm before the storm” as the risk of countries experiencing outbreaks climbs.
“It’s critical that countries vaccinate as quickly as possible against COVID-19, but this requires new resources so that it does not come at the cost of essential immunization programs. Routine immunization must be protected and strengthened; otherwise, we risk trading one deadly disease for another,” said Dr. O’Brien.
Twenty-six countries experienced major measles outbreaks last year, which made up 84% of all reported cases.
The COVID-19 pandemic also disrupted immunization services, postponing 24 measles vaccination campaigns in 23 countries and leaving more than 93 million at risk of catching the disease, the report says. The campaigns help people who have missed their measles shots by hosting routine immunization programs.
Measles is one of the most contagious human viruses in existence, but its spread can almost be entirely halted through vaccination, the WHO and CDC said. The measles vaccine is estimated to have saved more than 30 million lives worldwide.
An estimated 7.5 million people globally had measles in 2020, according to the report.
Eighty-one countries had managed to hold onto their measles elimination status despite the pandemic by the end of last year, WHO and CDC said. However, there were no new countries that succeeded in eliminating measles.
The report also notes there are still 15 countries that haven’t introduced the second dose of the measles vaccine into their national immunization schedules.
As of Nov. 3, a total of 47 measles cases were reported by four U.S. jurisdictions, CDC data shows. Last year, there were 13 individual cases of measles confirmed in eight jurisdictions. In 2019, the U.S. confirmed more than 1,200 measles cases in 31 states — the largest number of infections reported in the nation since 1992. Most of the cases were among people who were not vaccinated against measles.
The measles virus lives in the nose and throat mucus of an infected person and can spread through coughing and sneezing. The disease is particularly dangerous for babies and young children. The CDC says measles is so contagious that if someone has it, then up to 90% of those close to that sick person who are not immune will also become infected.
Symptoms of measles include rash, high fever, cough, runny nose and red, watery eyes. The CDC says children should get their first measles vaccine dose between 12 and 15 months of age and the second one between the ages of 4 and 6.